Individual
DR. LEWIS EDWARD GORE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1787 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827-9133
(803) 632-3421
Mailing address
406 S MAIN ST, SYLVANIA, GA 30467-2226
(843) 446-2461
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7872
SC
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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